High BMI Associated With Cardiotoxicity in Patients With Breast Cancer

By Tamara Thomas - September 11, 2023

Patients with high body mass index (BMI) being treated for breast cancer experienced heart damage or cardiotoxicity during chemotherapy, according to a study presented at the American College of Cardiology (ACC) Latin America 2023 Together With Asociación Costarricense de Cardiología, San José, Costa Rica.

Over the last few decades, breast cancer survival rates have improved considerably in Colombia. However, factors that increase the risk of cardiovascular side effects, like cardiotoxicity in patients, are not well-documented. For this study, Dr. Vetteh Santos and colleagues looked at a database of breast cancer patients who started chemotherapy with doxorubicin or trastuzumab between January and December 2021.

The study included 67 patients with an average age of 55 and a mean BMI of 26.18 kg/m². The patients had an echocardiogram at the start of the study and at least 1 follow-up echocardiogram.

The researchers found that about 12% of patients with a high BMI treated for breast cancer at a regional center experienced heart damage or cardiotoxicity during chemotherapy.

“Cardiotoxicity is a relatively recent concern in cancer care, and its recognition as a significant issue is still evolving,” Dr.  Santos wrote. “In regions with limited research infrastructure and resources, there may be a lack of specific studies or initiatives addressing cardiotoxicity in the context of breast cancer treatment.”

In addition, the researchers found that being overweight or obese (BMI ≥25) was the only predisposing risk factor for developing cardiotoxicity.

“Obesity is itself a risk factor for the development of breast cancer and cardiovascular disease like heart failure but it isn’t often properly managed, unlike other prevalent risk factors like high blood pressure,” said Dr. Santos.

The researchers also noted that chemotherapeutic agents, formulated according to body surface area rather than body composition, may increase cardiotoxicity in obese patients due to overdosing or underdosing. They added that early diagnosis of cardiotoxicity and related factors is essential for treating clinicians to reduce adverse outcomes.

In conclusion, the researchers suggest raising awareness of cardiotoxicity in cancer treatment through enhanced medical education, multidisciplinary collaboration, increased research, and the use of digital resources.

“Addressing obesity in cancer patients before starting chemotherapy as well as considering the potential risk for cardiotoxicity requires a comprehensive approach,” Dr. Santos concluded. “Some strategies clinicians can consider include pre-treatment assessment, lifestyle interventions and cardiovascular risk management. It is important to note that these strategies should be tailored to each patient’s specific needs and in accordance with current evidence-based guidelines.”

Source: Medical Net news

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